Diarrhoeal disease surge claims 54 each day

The Health ministry has reported increase in diarrhoeal diseases, with the country losing up to 54 children daily due to the preventable water-borne infections. 

This detail is contained in the Health –National Adaptation Plan (H-NAP) document and internal data presented during the Thursday launch by the government. The ministry disclosed in the document that the burden could be worsened if the country doesn’t step up efforts to mitigate and adapt to climate change.

“The incidence of diarrhoeal diseases rose from 3.3 per 10,000 in 2020 to 3.7 per 10,000 in 2023, with the Kampala region reporting the highest incidence at 12.2 per 10,000, followed by Bugisu at 6.4 per 10,000, and Tooro at 5.7 per 10,000. The impacts of climate change on the incidence of diarrhoeal diseases are likely to aggravate the occurrence of cholera and typhoid outbreaks,” the document reads.

The ministry attributed this rise in diarrhoeal diseases to climate hazards such as flooding and surface runoff that compromise water quality, accelerate the breeding of disease vectors such as flies, and enhance pathogen transmission.

“An increase in temperature also contributes to the proliferation of pathogens in food and water sources, further amplifying disease transmission. Thus, waterborne diseases, such as typhoid and cholera, remain on the increase, largely affecting children,” the document reads further.

Dr Herbert Nabaasa, the commissioner for environmental health department at the ministry, said some of these infections result from broken water, sanitation and hygiene (WASH) facilities due to flood-related havoc.

He added: “So, people start drinking contaminated water resulting in outbreaks such as diarrhoeal diseases and others. We are talking about 54 people dying daily [because of diarrhoeal disease]. I think this is more than what Covid was killing daily [in Uganda]. We need interventions moving forward.”

Handwashing tail-off

Health experts, however, have also warned that following the decline in Covid-19 cases, many people stopped adhering to basic hygiene practices—such as handwashing—known to reduce diarrhoeal disease spread. According to information from the World Health Organisation, in eight community-based trials, including 14,762 participants, handwashing promotion reduced the incidence of diarrhoea by 28 percent. 

Dr Nabaasa said besides diarrhoeal diseases, there is also a rising burden of malaria and air pollution-related diseases that the H-NAP seeks to tackle. He said there are more than 1,000 annual deaths in Kampala due to air pollution from factories and other sources. 

“Because of the climate change challenges, the rising temperature, we are seeing changes in the growth rate of mosquito larvae. We have seen almost the population of mosquitoes tripling and it has become harder to manage mosquitoes because of the growing rate of the larvae in different areas. We have now declared malaria as an epidemic,” he noted.

Dr Diana Atwine, the Health ministry’s permanent secretary, noted that H-NAP was a requirement at last year’s global climate convention where all countries committed to come up with the plan. She said the main agenda was how each country was going to adapt to the environmental effects as well as manage the vulnerability that comes with climate change-related issues.

“Uganda is the first in Africa to come up with this plan, and this plan looks at different components. We are looking at how we can strengthen the workforce, how we can build systems that are able to respond to emergencies, how we can have information systems that are able to detect and predict [epidemics],” she said.

Work cut out

On whether the H-NAP will be implemented to address the existing and emerging health challenges linked to climate change, Mr William Asiko, the vice president of Rockefeller Foundation, said they would support the government. The Foundation supported the Makerere University School of Public Health, and the government to develop H-NAP.

“Governments around the world are always trying to balance priorities because resources are limited. And sometimes, things do fall by the wayside just because the resources are not sufficient,” he said.

“We do take the initiative when we work with governments, not just to develop plans but also to continue to work with them through technical assistance to ensure that those plans are taken from the document and are actualised into programmes that move forward,” he added.

Dr Atwine on the other hand noted: “This H-NAP has different components, different agencies, and government organisations. They have to individually go and have their own plan because this one launched is for health but it feeds into different action plans of different agencies because this climate change issue is not just a minister of Health issue.”

“We are always unlucky that we get the aftereffects of flooding, diseases, displacement, hunger, malnutrition. All those things keep on coming back to us, but we think that we can do more to mitigate these factors if we bring everybody on board,” she added.

Ms Rukia Nakadama, the third deputy prime minister and minister without portfolio, said the Office of the Prime Minister would coordinate efforts to implement the plan.